U.S. Department of Health & Human Services

Managed Care Enrollment by Program and Plan

Name: Managed Care Enrollment by Program and Plan
Creator: U.S. Department of Health & Human Services

Medicaid managed care enrollment statistics, detailing point-in-time participation counts in various programs and plans. Each record includes the city, state, and two associated business names for the managed care entity.

Example records

Cityaddress	Stateaddress	Namelegal entity	Alternate Namebrand

Use cases

Managed Care Entity Alias Matching for KYB Onboarding

A fintech onboarding a Medicaid managed care organization as a payment processing client cross-references the legal entity name against the secondary business name to detect whether the organization operates under a trade name, reducing false negatives in entity resolution and sanctions screening.

NameAlternate NameState

State-Level Market Sizing for Healthcare Sales Teams

A health IT vendor mapping sales territories counts distinct managed care plans active in each state to prioritize outreach, identifying which states have the highest concentration of Medicaid managed care organizations as prospective buyers.

StateCityName

Counterparty Name Discrepancy Flagging in Claims Processing

A healthcare insurer reconciling subcontractor agreements checks whether the name on a contract matches either the legal entity name or the secondary business name in enrollment records, flagging discrepancies that could indicate unauthorized plan substitution or billing fraud.

NameAlternate NameStateCity